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侵入性心血管操作引起的临床和亚临床急性脑损伤。

Clinical and subclinical acute brain injury caused by invasive cardiovascular procedures.

作者信息

Lenarczyk Radosław, Proietti Marco, Scheitz Jan F, Shah Dipen, Siebert Eberhard, Gorog Diana A, Kowalczyk Jacek, Bonaros Nikolaos, Ntaios George, Doehner Wolfram, Van Mieghem Nicolas M, Nardai Sandor, Kovac Jan, Fiszer Roland, Lorusso Roberto, Navarese Eliano, Castrejón Sergio, Rubboli Andrea, Rivera-Caravaca José Miguel, Chieffo Alaide, Lip Gregory Y H

机构信息

Department of Cardiology and Electrotherapy, Silesian Centre for Heart Diseases, Zabrze, Poland.

The Medical University of Silesia in Katowice, Faculty of Medical Sciences in Zabrze, Zabrze, Poland.

出版信息

Nat Rev Cardiol. 2025 Apr;22(4):273-303. doi: 10.1038/s41569-024-01076-0. Epub 2024 Oct 11.

Abstract

Over the past 50 years, the number and invasiveness of percutaneous cardiovascular procedures globally have increased substantially. However, cardiovascular interventions are inherently associated with a risk of acute brain injury, both periprocedurally and postprocedurally, which impairs medical outcomes and increases health-care costs. Current international clinical guidelines generally do not cover the area of acute brain injury related to cardiovascular invasive procedures. In this international Consensus Statement, we compile the available knowledge (including data on prevalence, pathophysiology, risk factors, clinical presentation and management) to formulate consensus recommendations on the prevention, diagnosis and treatment of acute brain injury caused by cardiovascular interventions. We also identify knowledge gaps and possible future directions in clinical research into acute brain injury related to cardiovascular interventions.

摘要

在过去50年里,全球经皮心血管手术的数量和侵入性都大幅增加。然而,心血管介入手术在围手术期和术后都固有地存在急性脑损伤风险,这会损害医疗结果并增加医疗成本。目前的国际临床指南通常未涵盖与心血管侵入性手术相关的急性脑损伤领域。在本国际共识声明中,我们汇总了现有知识(包括关于患病率、病理生理学、危险因素、临床表现和管理的数据),以制定关于预防、诊断和治疗心血管介入所致急性脑损伤的共识性建议。我们还确定了与心血管介入相关的急性脑损伤临床研究中的知识空白和可能的未来方向。

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